Health Bill [HL]

Amendment 52 and the other amendments in this group are in large part about information and support and the training that goes with that. I have enormous sympathy with the considerations that have prompted Amendments 63A and 69B, tabled by the noble Baronesses, Lady Wilkins and Lady Campbell, and I support the probing amendments tabled by the noble Baroness, Lady Barker. Very few patients will be able to purchase services on their own without well informed support and advice. If we want direct payments to succeed in their health outcomes and to achieve the best value for money, patients will need advice to help them to take decisions and make choices. One of the problems that certain people foresee with direct payments is the lack of a level playing field when it comes to informing patients about the services on offer and from whom. I do not want to knock GPs, but if a patient receives advice only from a GP who is a service provider, how will that patient get a balanced picture of other, perhaps equally good, alternative ways of spending the budget: for example, via a local pharmacist? I know that the pharmacy profession is anxious about this. A pharmacist may set up in an area and invest in order to provide a first-class service, but if no one knows about it, it will cease to exist. If we look at eye care, an example that I raised earlier that is not in the normal field of general medical practice, we need to make sure that those who advise patients about the services they can buy with their budget know about the full range of services available to those patients and which services are good. For instance, if no one tells you that you can receive eye care services in your own home, the system is falling short. The other brief point that I wanted to make was about accreditation, which we debated earlier. To the extent that healthcare services are being provided on the NHS but by non-NHS providers, should we not encourage a system whereby service providers are kite-marked for quality? I realise that patients will not make choices entirely on their own. Nevertheless, without some form of quality assurance and accreditation system in place, the market could become a minefield in certain areas. I would be glad if the Minister could comment on that. I beg to move.